[mentalhealth-l] Resources for School Staff Responding to a Natural Disaster

[SMHP]

September 2, 2008

From: UCLA Center for Mental Health in Schools

Re: Resources for School Staff Responding to a Natural Disaster

Those concerned with mental health in schools and 
addressing barriers to learning and teaching know 
there is much to do in the aftermath of the hurricane and evacuations.

As soon as school opens, despite their own 
suffering, school personnel will need to hit the 
ground running in providing social and emotional 
supports for students and staff. Hopefully, they have prepared for this.

And, with the next hurricane on the way and 
tornadoes, floods, wildfires and other natural 
disasters always a threat, the rest of us need to 
use this as another reminder of the need to 
prepare before the next event in our locale.

We want to remind everyone that there are a 
variety of online resources available for 
aftermath support and for planning in 
anticipation of future events (see below).

Also, in order to get on top of lessons learned, 
we plan to devote our Practitioner Listserv for 
the next few weeks to the matter of student and 
staff support in anticipation of and in the 
aftermath of a natural disaster. If you are not 
on this listserv, you may want to sign on. (Just 
reply to this and tell us to add you.) And, we 
encourage everyone to send us anything they can 
share to help those affected already and as aids 
for future planning. We will circulate whatever 
we get as widely and quickly as feasible.

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School Support for Students and Staff Affected by Natural Disaster

On the home page of our website is a circle 
"Responding to a Crisis" to provide an easy 
access to resources when you most need them.  Go to http://smhp.psych.ucla.edu

As natural disasters affect communities and their 
schools, we want to make the most relevant 
resources easily accessible (i.e., earthquakes, 
wildfires, floods, tornadoes, hurricanes).

In the links to materials related to "Resources 
for Responding to and coping with Hurricane 
related events" 
http://smhp.psych.ucla.edu/hurricane.htm , you 
will see guides for anticipating the reactions of 
students and families and how schools can play a role in recovery.

Here are excerpts from several resources you can link to from this site:

(1) From Hurricane-related Distress, FSU Traumatology Institute (C. Figley)

"There are four phases each with its own set of demands or stressors

I.  Anticipation and Preparation: Starts from warning to impact
Human reactions range from panic buying and 
preparing to hostile avoidance and denial. Best 
to attempt to gain as much control over stress as 
possible by making effective preparations...
II. Disaster Impact. Lasts as long as there is perceived immediate danger
Associated with seeking safety and making mental 
notes of what was done right to cope and stay 
safe. Keep mind occupied, especially if very fearful..
III.  Immediate Post-Disaster Impact.
Starts with return to a sense of safety and ends 
with a sense of normality. Most dangerous phase 
because of effort to return home is risky. There 
is a desperate need try to return to normal. 
Greatest interests are what happened to my stuff 
and loved ones, should we rebuild or vacate, what is best for my family.

Coping with Anxiety During Phase III
Parents must be on the same team and focus on the 
welfare of the children first.

Be patient and flexible with children's behavior 
and reactions (both physical and emotional).

Kid's reactions (like adults) vary greatly: they 
have suffered losses too, and it's natural for 
them to express disbelief, anger, sadness, anxiety and depression afterwards.


Emotions of hurricane survivors often follow a 
roller coaster pattern of changes in mood, 
emotion, energy --- can change unexpectedly.

Children, in particular, resent the shattering of 
their routine. That resentment may manifest 
itself in enormous guilt, nightmares, temper tantrums and problems at school.
IV. Long-term Post-Disaster Impact.
Starts after a sense of normality and never ends 
with elevations. Longest phase is associated with 
creating a new normal, grieving the losses, 
thankful it was not worse and potential growth, 
efforts to recover by drawing upon own personal 
and social resources, some need help in doing so. 
Most recover completely unless there are other 
emotional issues or mental disorders (e.g., 
previous trauma, grief of loss, depression, storm-related phobia)....
Mental health experts say the unscathed often 
suffer "survivor's guilt.'' People suffering 
survivor's guilt often push themselves to the 
limit trying to help.  There is a natural 
grieving process –  denial, questioning, 
acceptance and recovery -- after the loss of 
normalcy, loved ones and property.

(2) From National Association of School 
Psychologists, Communique, Vol 33, #4 (F. Zenere)
"Hurricane experiences provide lessons for the future"

...A single natural disaster striking a 
particular region has the potential to cause 
significant damage, lead to widespread disruption 
and displacement, and heighten the level of human misery
...School districts can bolster their readiness 
for disaster response and recovery by assuring 
that crisis management policy, procedures and 
training activities reflect the environmental 
challenges common to their communities. Such 
actions should include the development of 
inter-agency and inter-district collaborative 
agreements that foster sharing of human and 
material resources during periods of acute need. 
Further, equipping school mental health 
professionals with the skills to offer guidance 
during the post-disaster response and recovery period is paramount.

Response and Recovery
... hurricane impact frequently leads to an 
elongated period of school closure. This time 
frame can and has been utilized efficiently, to 
prepare for the reopening of schools...The 
importance of bringing school mental health and 
instructional staff back to school well in 
advance of students can not be overstated. These 
caregivers need the opportunity to share and sort 
through their own disaster related experiences 
prior to addressing the needs of students. 
Further, instructional personnel can be charged 
with the responsibility of determining the 
current status of their students. Key information 
regarding damage to homes, potential relocation, 
loss or injury of family members and/or pets, and 
food, clothing and school supply needs, is vital 
in supporting a child's successful transition back to school.

School facilities are often designated as 
disaster evacuation shelter sites. These venues 
provide residence for many who have lost their 
homes as a result of disaster, and also provide 
an opportunity for school officials to assess 
family and child needs. Likewise, Disaster 
Recovery Centers (DRC) operated by the Federal 
Emergency Management Agency (FEMA), are set up in 
heavily impacted communities to support the 
reestablishment of basic needs and 
infrastructure. It is recommended that school 
district officials, including mental health 
professionals, be present in all DRC's to 
disseminate information and provide guidance for 
parents seeking support for their children.
School Reentry
With the exception of the resumption of basic 
services (e.g., water and electricity) and the 
provision of basic needs (e.g., food and 
shelter), no other occurrence better represents 
the initial phase of a community's post-disaster 
recovery than the reopening of schools. The 
closing of school triggers a disruption in the 
continuity of a child's life, which may lead to 
emotional and behavioral destabilization. In 
contrast, the return to school can provide a 
child with the healing environment of routine and 
structure, concrete expectations and 
predictability, and peer camaraderie and support; 
all of which are essential elements for 
reestablishing a sense of safety and security, 
and set the foundation for academic achievement.
Triage
Although the vast majority of students returning 
to school following a hurricane will be impacted 
by their disaster experience, very few will 
actually be traumatized. Post-disaster reactions 
can be best characterized by widespread distress, 
moderate behavioral changes and minimal 
occurrences of psychopathology. Numerous factors 
may influence a child's reaction(s) to storm 
exposure, including nature of warning, speed of 
onset, proximity, perceived level of threat, fear 
of loss of life, exposure to death and 
destruction, duration and sensorial perceptions.
Children most at risk for the development of 
post-disaster emotional difficulties that impact 
functioning are those who feel that their lives, 
or the lives of loved ones, are in jeopardy 
during the storm. Experiences marked by feelings 
of terror and helplessness are also highly 
correlated with post traumatic stress 
reactions...Children who may have had previous 
exposure to, and unresolved issues surrounding, 
trauma situations, including disasters, as well 
as youth with pre-existing psychopathology, also 
demonstrate an elevated risk for post-disaster difficulties.


Additional factors predictive of long-term 
emotional impact include children who were very 
upset during and after the disaster; those who 
lost their home or possessions; those who had to 
relocate to new homes and/or schools; and those 
children who attended schools that were forced to 
move to double sessions or make significant schedule adjustments.
Developmental Issues
Teachers and parents should be prepared to 
confront numerous emotional and behavioral issues 
that may influence a student's ability to cope 
with their disaster experience and could also 
impact school performance. Children of elementary 
school age may exhibit a spectrum of post 
disaster reactions including a wide array of 
fears, regressive behavior, behavioral 
difficulties, depressive symptoms and school 
difficulties. Following a lengthy period of 
school closure, young children may re-experience 
separation anxiety issues when leaving their 
parents, often out of concern of potential harm 
occurring to a family member in their absence. 
Other concerns include fear of the dark, 
especially if the storm occurred during evening 
hours; and for some very young children, a fear 
that they may have caused the disaster. The 
aforementioned reaction is consistent with the 
developmental characteristics of magical thinking 
and egocentric perspective, commonplace among 
pre-kindergarten to early elementary age children.
A child's ability to concentrate and focus 
sustained attention on a task may be especially 
compromised. The disaster experience along with a 
multitude of environmental disruptions may also 
influence the development of hyperactive and/or 
general acting out behavior, nightmares and other 
sleep disturbances, which in turn may lead to a 
decline in academic success. Similarly, 
adolescents may demonstrate in-kind reactions 
consistent with their elementary age 
counterparts. Additionally, teenagers are 
increasingly likely to elicit risk behaviors, 
including drug use, sexual acting out, dropping 
out of school, and antisocial and/or suicidal 
behavior, in response to their disaster-related exposure.

Attention must also be directed to the 
multiplicity of losses that accompany disaster. 
The death of a loved one or pet, destruction of 
one's home, missing material possessions or 
relocation to a new school all represent tangible 
losses that impact recovery. Moreover, intangible 
factors including a decline in a child's sense of 
safety and security, and eroding trust in 
parents/adults as protective agents, further lead 
to an increase in emotional distress.

Supporting Recovery
School mental health professionals can perform a 
variety of functions that support student 
adjustment and resiliency following a disaster 
experience. Serving as consultants, advocates, 
trainers and interventionists, they possess the 
skills that help to provide the foundation for 
recovery. The extension of support services is 
highly dependent upon the receptivity of school 
leadership. Once an invitation is extended, the 
mental health professional is in position to 
advocate for "best practice" approaches for 
addressing the educational, social and emotional 
needs of children, families, and school personnel 
impacted by the disaster. ...School mental health 
professionals should encourage teachers to 
maintain the routine and structure familiar to 
students prior to the disaster. However, efforts 
should be taken to alter workload expectations 
and avoid the introduction of new material during 
the transitional school reentry period. The 
following recommendations are provided for 
teachers to assist students in making a 
successful return to school in the aftermath of disaster:

·       Meet and greet students as they enter the classroom.
·       Remain calm and reassuring.
·       Acknowledge and normalize feelings/reactions.
·       Provide opportunities for children to share their concerns.
·       Promote and praise positive coping and problem solving skills.
·       Involve children in activities that 
permit them to make choices and re-establish some 
control over their environment.
·       Involve students in recovery-oriented activities and projects.
·       Consider the developmental stage and experiences of each child.
·       Incorporate disaster-related information into the curriculum.
·       Provide collaborative activities that 
strengthen student's friendships and support

The judicious use of Psychological First Aid 
(PFA) can be a helpful tool for the school mental 
health practitioner. PFA can be utilized to 
respond to the acute desire to share one's 
disaster experiences; provide information 
regarding future expectations;  provide 
information about risk indicators for the 
development of Post-Traumatic Stress Disorder 
(PTSD); and examine what symptoms/behaviors 
should signal help seeking. When employed 
appropriately, PFA may accomplish the following objectives:

·       Provide a sense of comfort, calm, reassurance and support
·       Provide an accurate account of the individual's experience
·       Respect individuals that decline the 
opportunity to discuss their experience
·       Promote acceptance and validation of reactions and feelings
·       Emphasize the importance of social support connections
·       Enhance problem solving ability
·       Address fears and anxieties
·       Reduce stigma and shame
·       Disseminate information important to the recovery process
·       Emphasize that help is available

Responding to the array of emerging student 
symptoms and behaviors will challenge school 
personnel during the post disaster period. School 
mental health professionals can assist teachers 
in providing timely information and guidance for 
addressing anticipated features, including 
psychosomatic complaints, aggressive or acting 
out behaviors, and despondency over disaster- 
related losses. Bereavement groups can be 
established in schools to provide grieving 
students the opportunity to process the 
multiplicity of losses that are common outcomes 
of natural disaster. The presence of complicated 
grief, PTSD, or depressive/suicidal behaviors, 
should result in immediate parent/guardian 
contact and referral to appropriate community-based mental health resources."

(3) There are several helpful resources from the 
National Child Traumatic Stress Center http://www.nctsnet.org

 From Recovery: After a Hurricane

"After a hurricane most families can be expected 
to recover over time, particularly with the 
support of family, friends, and organizations. 
The length of recovery will depend upon how 
frightening the hurricane was, if evacuation from 
home was necessary, and the extent of the damage 
and loss. Some families will return to their 
normal routine fairly quickly, while others will 
have to contend with destruction to their home 
and possessions, obtaining medical care, and 
overcoming financial hardship. Some families will 
have lost a loved one or a pet. Others will need 
to adjust to school closings or changes in school schedule.

Children's functioning will be influenced by how 
their parents and other caregivers cope during 
and after the hurricane. Children often turn to 
adults for information, comfort, and help. 
Parents and teachers should try to remain calm, 
answer children's questions honestly, and respond as best they can to requests.

Children's Reactions
Children react differently to a hurricane and its 
aftermath depending on their age, developmental 
level, and prior experiences. Some will respond 
by withdrawing, while others will have angry 
outbursts. Still others will become agitated or 
irritable. Parents should attempt to remain 
sensitive to each child's reactions. The 
following are typical reactions children might 
exhibit during any natural disaster:
· Fear and worry about their safety or the safety of others, including pets
· Fear of separation from family members
· Clinging to parents, siblings, or teachers
· Worry that another hurricane will come
· Increase in activity level
· Decrease in concentration and attention
· Withdrawal from others
· Angry outbursts or tantrums
· Aggression to parents, siblings, or friends
· Increase in physical complaints, such as headaches and stomachaches
· Change in school performance
· Long-lasting focus on the hurricane, such as 
talking repeatedly about it or acting out the event in play
· Increased sensitivity to sounds of thunder, wind, or things crashing
· Changes in sleep patterns
· Changes in appetite
· Lack of interest in usual activities, even playing with friends
· Regressive behaviors, such as baby-talk, bedwetting, or tantrums
· Increase in risky behaviors for teens, such as 
drinking alcohol, using substances, harming 
themselves, or engaging in dangerous activities

What You Can Do to Help Your Child

Parents should spend time talking to their 
children, letting them know that it is okay to 
ask questions and to share their worries. Issues 
may come up more than once and parents should 
remain patient and open to answering questions 
again and needing to clarify things. Although it 
will be hard finding time to have these 
conversations, parents can use regular family 
mealtimes or bedtimes to talk. They can let 
children know what is happening in the family, 
with their school, and in the community. They 
should answer questions briefly and honestly and 
be sure to ask their children for their opinions 
and ideas. For younger children, after talking 
about the hurricane, parents might read a 
favorite story or have a relaxing family activity 
to help them feel more safe and calm.

To help children's recovery, parents should:
 > Be a role model. Try to remain calm, so your 
child can learn from you how to handle stressful situations.

 > Monitor adult conversations. Be aware of what 
adults are saying about the hurricane or the 
damage. Children may misinterpret what they hear 
and be unnecessarily frightened.

 > Limit media exposure. Protect your child from 
too many images of the hurricane, including those 
on television, on the internet, on radio, and in the newspaper.

 > Reassure children they are safe. You may need 
to repeat this frequently even after the 
hurricane passes. Spend extra time with them, 
playing games outside, reading together indoors, 
or just cuddling. Be sure to tell them you love them.

 > Replace lost or damaged toys as soon as you are able.

 > Calm worries about their friends' safety. Even 
though phones may not be working, reassure your 
children that their friends' parents are taking 
care of them, just the way they are being taken care of by you.

 > Tell children about community recovery. 
Reassure children that things are being done to 
restore electricity, phones, water, and gas. Tell 
them that the town or city will be removing 
debris and helping families find housing.

 > Take care of your children's health. Help them 
get enough rest, exercise, and healthy food. Be 
sure they have a balance of quiet and physical activities.

 >Maintain regular daily life. Even in the midst 
of disruption and change, children feel more 
secure with structure and routine. As much as 
possible, keep to regular mealtimes and bedtimes.

 >Maintain expectations. Stick to your family 
rules about good behavior and respect for others. 
Continue family chores, but keep in mind that 
children may need more reminding than usual.

 > Encourage children to help. Children cope 
better and recover sooner if they feel they are 
helping out. Give them small clean-up tasks or 
other ways to contribute. Afterward, provide 
activities that are not related to the hurricane, 
such as playing cards or reading.

 > Be extra patient once children have returned 
to school. They may be more distracted and need 
extra help with homework for a while.

 > Give support at bedtime. Children may be more 
anxious at times of separation from parents. 
Spend a little more time talking, cuddling, or reading than usual...


 > Help with boredom. Daily activities, such as 
watching television, playing on the computer, and 
having friends over, may have been disrupted. 
Extracurricular activities, like sports and or 
dance classes, may have been suspended. Help 
children think of alternative activities to do...

 > Keep things hopeful. Even in the most 
difficult situation, it is important to remain 
optimistic about the future. Your positive 
outlook will help your children be able to see 
good things in the world around them. This will 
help get them through even the most challenging times.


 > Seek professional help if your child still has 
difficulties more than six weeks after the hurricane.
 From Teacher Guidelines for Helping Students after a Hurricane
  National Child Traumatic Stress Network. http://www.NCTSNet.org

"Students who have been through a hurricane often 
have difficulties with concentration, attention, 
and behavior. Some students may be very quiet and 
withdrawn, while others may be disruptive and 
overly active. Many will have difficulties with learning.
• Modify lesson plans. They may have to be 
adapted over the recovery period to reduce the 
class''s workload, move at a slower pace, and be more enjoyable.

• Communicate with students. Be open to talking 
with students about their feelings and concerns 
about the hurricane. It is important to provide 
accurate factual information to help clarify 
misunderstandings and reduce fear. End the 
discussion with focus on current safety 
procedures and helpful plans for coping.

• Know your students'' experiences. It is 
important to invite students and parents to let 
you know when a student is affected by some 
change in his or her personal life so that you 
can better understand any change in classroom behavior or school performance.

• Share information with others. It is important 
for teachers to speak with one another and other 
school staff to share information and monitor how students are doing.

• Provide structure. Maintain a predictable, 
structured class schedule with specific rules and 
consequences to provide support and consistency for your students.

• Refer distressed students for help. Teachers 
should encourage distressed students to meet with 
the school counselor, social worker, or nurse.

• Encourage your students. Teachers should 
encourage students to get appropriate rest and 
exercise and to eat a healthy diet.

• Set limits on anger. It is especially difficult 
for teachers to have students acting irritably or 
being disruptive, which may occur after a 
hurricane or any distressing event. One way to 
handle irritable, disruptive, or aggressive 
behavior is to be clear about the behavior that 
is expected and reinforce age-appropriate 
anger-management and conflict-resolution concepts 
to ensure a climate of nonviolence.

• Reduce reminders. Teachers should reduce their 
student''s exposure to unnecessary reminders of 
the hurricane. This includes limiting 
teacher-to-teacher conversations about the 
hurricane in front of students and limiting their 
exposure to television stories and images of the hurricane during class time.

• Identify sleep problems. Many students may 
suffer from lack of restful sleep. Tired students 
often cannot concentrate or learn well and can be 
irritable with friends and teachers. If a student 
is having any of these problems, it is important 
to ask them and their parents or caretakers about their sleep.

• Be patient. Recovery comes in stages over weeks 
and months. Don''t become discouraged because 
some students take more time than others or have temporary setbacks.

• Promote prosocial activities. It is very 
important to engage preadolescents and 
adolescents in prosocial activities to help 
rebuild their school community and social life. 
Prosocial activities are important to building a 
sense of community and citizenship. These 
activities can include a project to help improve 
their school or neighborhood or a project to help others in their community."
##########################################

Do you have resources that you would like us to 
share with others related to hurricanes or other 
natural disasters?  Please send them to ltaylor at ucla.edu

Is there something you need as your work with 
schools, families, staff, students recovering 
from the recent hurricanes?  Please let us know. Ltaylor at ucla.edu

As noted above, we plan to follow-up with 
specifics on our weekly Mental Health in Schools 
Practitioner Listserv.  If you would like to be 
included in this weekly sharing of specific 
concerns and sharing from mental health in 
schools practitioners, please let us know.  Just 
reply to this email or Email smhp at ucla.edu and 
ask to be added to the Practitioners' Listserv.


School Mental Health Project/
Center for Mental Health in Schools
UCLA Dept. of Psychology
Los Angeles, CA  90095-1563
(310) 825-3634 / Toll Free: (866) 846-4843 / Fax: (310) 206-8716
Email: smhp at ucla.edu
Web: http://smhp.psych.ucla.edu 
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